scholarly journals Comparative Randomised Study between Bupivacaine with Clonidine and Ropivacaine with Clonidine Used Caudally for Postopertaive Analgesia in Paediatric Hypospadias Surgery

2021 ◽  
pp. 97-105
Author(s):  
Aditi Shatalwar ◽  
Nikhil Bhalerao ◽  
Jui Jadhav ◽  
Dnyanshree Wanjari ◽  
Suhas Landge ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Sedation Score ◽  
Motor Blockade ◽  
Postoperative Vomiting ◽  
Microsoft Excel ◽  
Randomised Study ◽  
Post Operative Pain ◽  
Hypospadias Surgery ◽  
Caudal Epidural

Background: This study was conducted to compare and evaluate the caudal epidural clonidine when mixed with ropivacaine and bupivacaine in prolonging postoperative analgesia in children of Indian genotype undergoing hypospadias surgery, as well as compare the intraoperative haemodynamics using caudal bupivacaine with clonidine vs ropivacaine with clonidine. The study was also aimed at studying the side effects and the duration of post-operative pain relief of bupivacaine with clonidine v/s ropivacaine with clonidine. Methods: This is a prospective randomised comparative study that was carried out in the Department of Anaesthesiology, KEM Hospital, Pune, over 12 months (from October 2016 to September 2017), among 56 children having an ASA Grade of II, aged between 1 to 8 years admitted for hypospadias surgery. The data gathered was cleaned using Microsoft Excel, before statistical analysis was done. Results: It was observed that caudal epidural analgesic duration was more in the bupivacaine clonidine group than in the ropivacaine clonidine group. The sedation score was higher at the second hour in the bupivacaine clonidine group. The HR and mean arterial pressure values were found to be notably higher in the ropivacaine clonidine group than those in the bupivacaine clonidine group. Intraoperatively and postoperatively, there was a decrease in pulse rate and MAP but at no time did the value reach the criteria for intervention. Other side effects like postoperative vomiting, nausea, motor blockade, respiratory distress not observed in any group. Conclusion: Bupivacaine 0.25 % 0.5 ml per kg with clonidine 1 microgram / kg via caudal route increased the duration of postoperative analgesia with no adverse effects as compared to ropivacaine 0.25 % with clonidine 1 microgram/ kg. Hence clonidine is more efficient in increasing postoperative analgesia when added with Bupivacaine as compared to ropivacaine in Indian genotype in hypospadias surgery.

A Comparison of Naproxen, Indomethacin and Acetylsalicylic Acid in Pain after Varicose Vein Surgery

1978 ◽  
Vol 6 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Ulla Aromaa ◽  
Kari Asp
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Postoperative Analgesia ◽  
Varicose Vein ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Varicose Vein Surgery ◽  
Double Blind ◽  
Post Operative Pain ◽  
Minor Surgery

Oral naproxen in doses of 500 mg and 750 mg daily was compared with oral indomethacin, 75 mg daily, in a double-blind, completely randomized study of patients with post-operative pain after out-patient varicose vein surgery. Altogether, 120 patients were studied. In the study 750 mg naproxen proved to be equal in respect of analgesic efficacy to 75 mg indomethacin, and it was clearly superior to 1500 mg acetylsalicylic acid. Naproxen, 500 to 750 mg daily, afforded adequate postoperative analgesia in 98% of patients. The side-effects were mild. On the basis of the study, naproxen can be recommended as a pain-relieving drug after minor surgery, particularly when an antiphlogistic effect is also desirable.

scholarly journals Comparison of the Effects of Adding Dexmedetomidine Versus Midazolam to Intrathecal Bupivacaine on Postoperative Analgesia

2015 ◽  
Vol 18;1 (1;1) ◽  
pp. 71-77
Author(s):  
Aloka Samantaray
Keyword(s):  
Side Effects ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Sedation Score ◽  
Controlled Study ◽  
Saline Control ◽  
Control Group ◽  
Hyperbaric Bupivacaine ◽  
Midazolam Group ◽  
Effective Analgesia

Background: Dexmedetomidine and midazolam both modulate spinal analgesia by different mechanisms, and yet, no human studies are available to compare them for postoperative analgesia after neuraxial administration. Objectives: We investigated the addition of dexmedetomidine or midazolam to intrathecal bupivacaine on the duration of effective analgesia and clinical safety profile. Study Design: Prospective, randomized, double blind, placebo controlled study. Setting: University teaching hospital. Methods: The study cohort included a consecutive and prospective series of patients, referred for endourological procedures. The patients were randomly allocated into 3 groups (20 patients each) to receive intrathecally 3 mL of 0.5% hyperbaric bupivacaine in combination with 5 mcg of dexmedetomidine (dexmedetomidine group), 1 mg of midazolam (midazolam group) or 0.5 mL of 0.9% saline (control group). The groups were compared to the regression time of sensory block, duration of effective analgesia (defined as the time interval between administration of intrathecal drug to the time of first analgesic request or a numeric rating scale ≥ 4.0), sedation score, and side effects in the first 24 hours. Statistics: One way-ANOVA, Kruskal Wallis test, and Chi-square test (χ2), significance level: P < 0.05. Results: The duration of effective analgesia (time to first analgesic request) was significantly prolonged in the dexmedetomidine group (286 ± 64 minutes, P < 0.01) when compared with midazolam group (236.9 ± 64.9 minutes) and the control group (212.7 ± 70.2 minutes). Pairwise comparisons among the 3 groups with Bonferroni adjustment revealed that patients from the dexmedetomidine group were more sedated in comparison to the midazolam and control groups at the end of the first 15 minutes after intrathecal injection [χ2 (2) = 7.157, P = 0.028], with a mean rank sedation score of 35.58 for dexmedetomidine, 25.00 for midazolam, and 30.93 for control. No significant differences in the side effects were observed during the study period. Midazolam did not lengthen the time of the two segment sensory regression or the time to first request analgesia. Limitation: The study cannot be extrapolated to muscle cutting surgeries under spinal anaesthesia. Conclusions: The addition of dexmedetomidine (5 mcg) to 3 mL of intrathecal hyperbaric bupivacaine (0.5%) significantly prolongs the duration of effective analgesia in comparison to 1 mg midazolam or placebo (0.9% normal saline) with a comparable incidences of side effects. Key words: Dexmedetomidine, midazolam, intrathecal, spinal anaesthesia, subarachnoid block, postoperative pain Pain Physician 20

scholarly journals A New Look on Adding Dexamethasone as an Adjuvant to Caudal Bupivacaine; Efficacy on Postoperative Pain and Vomiting in Pediatric Patients

2016 ◽  
Vol 6;19 (6;7) ◽  
pp. E841-E852
Author(s):  
Dr. Sayed Kaoud Abd-Elshafy
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Postoperative Vomiting ◽  
Caudal Block ◽  
Dexamethasone Group ◽  
Number Of Patients

Background: Controlling postoperative pain and vomiting in children remains a great challenge. Objective: Study the efficacy of adding dexamethasone to caudal bupivacaine on postoperative analgesia and vomiting. Study Design: Prospective, randomized double blind controlled clinical trial. Setting: Assiut University Hospital. Patients: Ninety children ASA I-II, undergoing lower orthopedic surgeries. Methods: Patients were randomly allocated into 3 equal groups. All received caudal block after induction of anesthesia with 0.5 mL/kg of 0.25% bupivacaine in addition to 5 mL intravenous (IV) normal saline in the control group, IV 0.5 mg/kg dexamethasone in IV dexamethasone group and lastly 0.1 mg/kg dexamethasone in the caudal dexamethasone group. Postoperative pain scores and rescue analgesic consumption were recorded. Blood glucose, postoperative vomiting, and other side effects were evaluated up to 24 hours after extubation. Results: The time of first analgesia and the number of patients requiring rescue analgesics were significantly decreased with intravenous or caudal dexamethasone. No significant increase in postoperative blood glucose levels were observed. A significant increase in β- Endorphin level at 3 and 24 hours postoperative was found in both dexamethasone groups when compared with the preoperative baseline value. The incidence of postoperative vomiting was significantly decreased in both dexamethasone groups in comparison with the control group. No other side effects were detected. Limitations: Measurement of serum cortisol. Conclusion: Analgesic and antiemetic effects of dexamethasone as an adjunct to caudal block with bupivacaine (0.25%) 0.5 mL/kg is similar whether administered intravenously 0.5 mg/kg or caudally 0.1 mg/kg. Key words: B-Endorphin, bupivacaine, caudal, dexamethasone, pediatric, postoperative analgesia, vomiting

scholarly journals Comparision of Caudal Ropivacaine, Ropivacaine Plus Ketamine and Ropivacaine Plus Fentanyl Administration for Postoperative Analgesia in Children

2013 ◽  
Vol 32 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Jeevan Singh ◽  
Dikshya Hamal ◽  
Avish Karmacharya
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Saline Group ◽  
Normal Saline Group ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Caudal Analgesia ◽  
Lower Pain ◽  
The Mean ◽  
Fentanyl Administration

Introduction: The purpose of the study was to compare the analgesic quality and duration of Ropivacaine 0.2% with the addition of Fentanyl (1 mcg/kg) with that of Ropivacaine 0.2% and the addition of Ketamine (0.5 mg/kg) and also compare the post complications. Materials and Methods: Ninety children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of three groups: caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine in normal saline (Group R) or caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine with Ketamine 0.5 mg/kg (Group RK) or caudal analgesia with 0.75 ml/kg of 0.2% Ropivacaine with Fentanyl 1 mcg/kg (Group RF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results: The mean duration of analgesia was significantly longer in Group RK (629.06 ± 286.32 min) than other two groups P < 0.05. The pain score assessed using FLACC scale was compared between the three groups, and children in Group RK had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group RK. Ketamine in a dose of 0.5 mg/kg added to 0.2% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of Ropivacaine, without any side effects in compare to Ropivacaine alone or Fentanyl. Conclusion: We conclude that Ketamine in a dose of 0.5 mg/kg, added to 0.2% Ropivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia without any side effects. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6956 J. Nepal Paediatr. SocVol.32(3) 2012 210-215

scholarly journals Comparison of Effect of Clonidine Added to Bupivacaine-Fentanyl Mixture on the Quality of Spinal Anaesthesia and Peri-Op Analgesia with Bupivacaine-Fentanyl or Bupivacaine-Clonidine Mixture in Major Orthopaedic Lower Limb Surgeries

2017 ◽  
pp. 97
Author(s):  
Milin Raju Shah ◽  
Gauri Diwan
Keyword(s):  
Side Effects ◽  
Spinal Anaesthesia ◽  
High Dose ◽  
Motor Blockade ◽  
Randomised Study ◽  
Group I ◽  
Analgesia Requirement ◽  
Mean Time ◽  
Effective Analgesia

Introduction: With side effects of central neuroaxial opioids or of high dose intrathecal clonidine in combination with bupivacaine in spinal anaesthesia, my study is to ascertain if small dose of clonidine when added to bupivacaine-fentanyl mixture improves spinal anaesthesia, without producing side effects, as compared to bupivacaine-fentanyl or bupivacaineclonidine mixture. Methods: It’s a prospective, double blinded randomised study of 90 ASA grade I-II patients, aged between 20-60 yrs, of either sex, weighing between 40-70 kgs, scheduled for major orthopaedic surgeries. Patients were randomly divided into 3 groups of 30 patients each as Group I (BCF): Bupivacaine 0.5%H 2.6ml + Fentanyl 20mcg + Clonidine 30mcg Group II (BC): Bupivacaine 0.5%H 2.6ml + Clonidine 30mcg Group III (BF): Bupivacaine 0.5%H 2.6ml + Fentanyl 20mcg Duration of sensory and motor blockade and effective analgesia mean time till two segment regression, haemodynamic profile, post-op pain and analgesia requirement were recorded. Results: The duration of sensory and motor blockade, effective analgesia and mean time till two segment regression were significantly longer in group BCF as compared to group BC (P – 0.002) and in group BC as compared to group BF (P – 0.01). The incidence of intra-op pain and requirement of postop analgesia in the first 24 hours was significantly more in group BF as compared to other groups (P-0.01). Conclusion: Low dose Clonidine when added to Bupivacaine-Fentanyl mixture improves the quality of peri-op analgesia without significant side effects.

scholarly journals Comparative Efficacy of Intrathecal Pethidine with Lignocaine 5% (Heavy) as Sole Anaesthetic Agent for Perineal Operations

2020 ◽  
Vol 5 (1) ◽  
pp. 78-83
Author(s):  
Jitta Sudershan Reddy
Keyword(s):  
Body Weight ◽  
Side Effects ◽  
Postoperative Analgesia ◽  
Anaesthetic Agent ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Motor Paralysis ◽  
Group A ◽  
Group B ◽  
Preservative Free

Background: The discovery of opioid receptors and ligand in the brain and spinal cord lead to the feasibility of their use intrathecally. Pethidine is the only narcotic that has been shown to be effective intrathecally for surgery. This is probably because it as a phenyl-piperidine derivative and has a structure and action similar to that of local anaesthetic.Subjects and Methods:50 patients belonging to ASA grade 1 and 2 physical status were randomly assigned to two groups A and B. Patients in group A received 1 ml of 5% lignocaine (heavy) intrathecally and those in group B gained intrathecal Pethidine (preservative-free) 0.5mg/kg body weight. The time for onset and level of sensory blockade, onset and degree of motor blockade, hemodynamic parameters, time for regression of sensory and motor blockade, duration of postoperative analgesia and side effects were noted and compared in both the groups.Results:Two groups were comparable with respect to age, sex, height and weight. The onset of sensory and motor blockade in-group A was 2.00±1.06min and 2.56±0.88 and in-group B it was 3.56±1.64 min and 7.22±1.11 min respectively, which was statistically significant. Grade I motor paralysis was seen in 2 cases (10%) in group A and 15 cases (75%) in groupB. Grade II motor paralysis was seen in 6 cases (30%) in group A and 5 cases (25%) in group B. Grade III motor paralysis was viewed in 12 cases (60%) in group A and 0 cases(0%) in group B. Grade I and III motor paralysis in the groups were statistically significant (p<0.05). Time for sensory regression at L1 was 65.12±4.83 min in-group A and 94.60±6.88 min in-group B that was statistically very significant (p<0.05). The time for regression of motor blockade was 60.40±3.85 in-group A and 60.20±5.02 in group B, which was statistically not significant (p>0.05). The duration of postoperative analgesia was 122.84±9.37 min in-group A and 320.60±23.02 in group B, which was statistically very significant. The incidence of side effects was comparable in both groups.Conclusion:Pethidine (preservative-free) 0.5mg/kg body weight can be used intrathecally as a sole anaesthetic agent to provide prolonged postoperative analgesia associated with hemodynamic stability and early ambulation in patients undergoing perineal surgeries.

scholarly journals "COMPARISON OF ANALGESIC EFFECT OF INTRAMUSCULAR NALBUPHINE AND TRAMADOL IN POST OPERATIVE PAIN"

2020 ◽  
pp. 1-2
Author(s):  
Reema Vansola ◽  
Shivrajsinh Gohil ◽  
Maulik Zalavadiya ◽  
Rasida Garbadavala ◽  
Sanket Karkar
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Analgesic Effect ◽  
Effective Alternative ◽  
Post Operative Period ◽  
Post Operative Pain

Pain is omnipresent; is an intolerable sensation, which make patient vulnerable. It is well documented that pain is often inadequately treated, can be deleterious and can lead to number of complications in post-operative period. Nalbuphine and Tramadolare the drugs which we had compared here for there efficacy in postoperative analgesia and there side effects. IM Nalbuphine is safe and effective alternative for relief of moderate to sever postoperative analgesia compared to IM tramadol in equianalgesia doses.

scholarly journals COMPARISON OF CLONIDINE AND FENTANYL AS AN ADJUVANT TO INTRATHECAL 0.5% HYPERBARIC BUPIVACAINE IN PATIENTS UNDERGOING KNEE ARTHROPLASTY

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Anjali Bansal
Keyword(s):  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Demographic Data ◽  
Randomized Study ◽  
Sedation Score ◽  
Motor Blockade ◽  
Hemodynamic Parameters ◽  
Hyperbaric Bupivacaine ◽  
Lower Limb Surgery ◽  
Fentanyl Group

Background and Objective: Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery. This study was undertaken to compare the intraoperative effects and postoperative analgesia of fentanyl and clonidine, used as adjuvant to intrathecal bupivacaine during knee arthroplasty. Methodology: This prospective, randomized study was conducted on 60 patients of ASA grade I or II, between 20 and 50 years of age divided into two groups of 30 each. The patients were given 3 ml of 0.5% hyperbaric bupivacaine with either 25 mcg of fentanyl (Group F) or 50 mcg of clonidine (Group C) intrathecally. The onset of sensory and motor block, the duration of blockade, hemodynamic parameters, sedation score, total postoperative analgesia time, and side effects if any were recorded. Results: Both the groups were statistically comparable for demographic data, onset of sensory and motor blockade, duration of blockade and hemodynamic parameters. However, the sedation score was more in clonidine group. The duration of analgesia was significantly prolonged in clonidine group when compared with fentanyl group. Conclusion: In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score. Key words: Bupivacaine, clonidine, fentanyl

scholarly journals POSTOPERATIVE ANALGESIA;

2012 ◽  
Vol 20 (01) ◽  
pp. 095-098
Author(s):  
ASMA SAMEE ◽  
M. SHAFIQUE TAHIR ◽  
NADEEM AHMAD KHAN ◽  
Muhammad Masood ◽  
Muhammad Yousaf ◽  
...  
Keyword(s):  
Side Effects ◽  
Young Children ◽  
Respiratory Depression ◽  
Postoperative Analgesia ◽  
Low Frequency ◽  
Paediatric Anaesthesia ◽  
Postoperative Vomiting ◽  
Study Results ◽  
Group A ◽  
Group B

Objective: To compare the effects after caudal bupivacaine alone and bupivacaine-tramadol in young children with inguinalhernia repair. Setting: Department of Paediatric Anaesthesia, Children Hospital Complex, Multan. Period: August 2008 to May 2009.Material and methods: A total of 100 children aged between 2-5 years were included in the study. Results: The duration of analgesiawas significantly prolonged in group-A patients (P=0.001). A low frequency of postoperative vomiting was observed in both groups i.e.10% in group-A and 6.7% in group-B (P=0.64). No respiratory depression, flushing and pruritis were observed. Conclusions: Low dosecombination of bypivacaine and tramadol, when administered caudally, had an additive effect and provided prolonged and effectivepostoperative analgesia with minimal side effects.

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